Report Inappropriate Comments

Thank you for supporting the OHIC rate increases for behavioral health and home-based service providers.

What is missed in Mr. DiBiase's article is the reason Rhode Island's Medicaid costs are high and rising so fast. In fact, Rhode Island spends more per Medicaid enrollee than other New England states. The reason is that we spend our money on the wrong end of the healthcare continuum. We are penny-wise and pound foolish! All our upstream outpatient rates for behavioral health, human services, and outpatient medical care are on average 30% below our sister states. Behavioral health providers have waiting lists and there is a lack of primary care doctors. Thus, people do not access care until they are in a crisis, suicidal, overdosed, or extremely sick. They end up in a hospital emergency department or inpatient bed. Rhode Island's high Medicaid costs, other than the increase in enrollment, is because the money spent is disproportionately in high-cost hospital services. We also do not invest in the right effective evidenced-based practices which have a return on investment of saving over two dollars in healthcare costs for every dollar spent on research-based outpatient care.

In community behavioral health all other states supplement their community provider system with blended state dollars in addition to Medicaid. How then can our overall cost per person and rate of increased Medicaid spending be higher than surrounding states when we pay providers less? Low outpatient rates!

We do not need more costly beds but need to invest in the right services.

Jamie Lehane